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Urinalysis vs. Urine Culture

The last time I thought I had a uti the doctor did a urinalysis and said everything was fine, but also decided to do a urine culture. The urine culture did not come back o.k., so I was put on antibiotics.

My question is why didn't anything show up on the urinalysis but it did on the culture? Was it necessary to treat the uti since the urinalysis came back o.k.? I have a vague idea of why, but I'm definitely not an expert.

There was another occasion about 8 months ago when the urinalysis came back o.k., and my doctor left it at that, and I don't believe she followed it up with a culture. She is just my regular doctor and has learned a lot with me as a patient...but I'm just curious now if the uti needed to be treated. I did have a low grade fever and several other symptoms at the time. And as I type this post, I have this horrible burning sensation in my back that I think must be attributed to yet another uti(this would make my 2nd uti in just over a month)...which brings me to another question.

Even though I have been on bactrim for about a year now, I continue to get uti's. I've probably been treated for at least 4. I know in past posts it has been suggested to look into underlying causes...what should I be looking for? Or is this really just normal.

Urinalysis (UA) primarily looks at the chemistry of the urine. It does include a gross microscope exam for white and red blood cells as well as casts, but it cannot determine either the number or type of bacteria. It is more important for telling you how your kidneys are working, and other biochemical functions of your body, although normal urine should not have white or red blood cells either. It does not tell you how many bacteria are present, which ones they are, or what antibiotic to use.

Only a culture and sensitivity (C&S) can tell you which bacteria are present, in what numbers, and what is the appropriate antibiotic should be used.